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Chapter 1

Chapter 1. Traditional and Community Nursing Care for Women, Families, and Children. Traditional Nursing Care. Historical Perspective. Medical Model Ethnopluralism Ethnocentrism. Shifts in Nursing. Health-Wellness Continuum Linear: illness to wellness

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Chapter 1

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  1. Chapter 1 Traditional and Community Nursing Care for Women, Families, and Children

  2. Traditional Nursing Care

  3. Historical Perspective • Medical Model • Ethnopluralism • Ethnocentrism

  4. Shifts in Nursing • Health-Wellness Continuum • Linear: illness to wellness • Circular: motivate family to health promotion, maintenance, and restoration • Nursing aesthetics

  5. Changing Demands and Demographics • Engaging transpersonal care • Social and technological advances • Family structure, function, and definition

  6. Contemporary Nursing Care

  7. Current Health Care Settings • Acute Care • Regional and Tertiary Centers • Birthing Centers • Home Care • Nurse-Managed Clinics • Increase in Nursing Responsibility and Judgment • Primary Care • Community-Based Care

  8. Family-Centered Care • Nurse as facilitator • Assists family in making informed choices toward outcome of patient/family • Cultural sensitivity • Cultural competence

  9. Modern Technology and the Caring Touch • Complementary/Alternative Medicine • Low-tech, high-touch interventions • Supports whole mind, body, energy, environment, and spiritual healing • Goal: patient-centered autonomy

  10. Touch vs. Tech • Evidence-Based Practice • Health Informatics • Professional Organizations/Standards of Care

  11. Professional Nursing Roles • Teacher • Collaborator • Provider of care • Nursing process • NIC • NOC

  12. Caring Theories • Nightingale’s model • Watson: Theory of Human Caring • Leininger: Theory of Transcultural Care Diversity and Universality

  13. Essential Caring Characteristics • Trust • Provide sense of empowerment • Communication • Spirituality • Meaning of life

  14. Additional Professional Nursing Roles • Critical thinker • Effective communicator • Advocate

  15. Nursing Process— Concept Map • Analyze assessment data to determine nursing problems/diagnoses • Analyze relationships, prioritize patient responses • Work with patient/family to develop goals • Select interventions • Evaluate progress

  16. Chapter 2 Contemporary Issues in Women’s, Family’s, and Children’s Health Care

  17. Public Health Intervention Model(The Intervention Wheel) • Population-based • Defines levels of practice • Comprehensive prevention focus • 17 categories of intervention tactics

  18. Public Health Intervention Model The Intervention Wheel

  19. How the Intervention Wheel Works • Childhood Obesity

  20. Healthy People 2010 • Defines health care priorities • Guide progress toward the ultimate goal of optimal health • Goals: • To increase the quality and years of healthy life • To eliminate health disparities within America’s population

  21. Healthy People 2010 (cont’d) • Comprehensive set of 467 measurable disease prevention and health promotion objectives • 28 focus areas • Leading health indicators

  22. Three Levels of Prevention • Primary prevention • Health promotion • Secondary prevention • Early identification and prompt treatment • Tertiary prevention • Restore health

  23. U.S. Health Care • Population is healthier than ever before • Heart disease declining • World Health Organization • U.S. is 37th in health care status

  24. Health Care Spending • U.S. spends more per capita • U.S. health care budget—1/7 of GNP • Health care disparities

  25. Selected Societal Trends • Epidemiology • Morbidity rates • Mortality rates

  26. Societal Trends (cont’d) • Aging population with more chronic illnesses • Increased racial and ethnic diversity • Health care disparities • Childbirth trends • Patterns of physical fitness

  27. Current Health Status

  28. Infants and Children • Decreasing infant mortality • Change to health prevention and early intervention • Health trends • Increase in asthma • Increased ADHD • Increased autism

  29. Current Health Status • Families • Access to health insurance • Women • Increased heart disease • Perinatal health

  30. Political Influences and Trends • Health Policy Decisions • Abortion • National Economic Policies • Access to care • Health Care Delivery • Managed care

  31. Public Policies and Programs • Women, Infants, and Children (WIC) • Medicaid • Newborn and Mothers Health Protection Act • Family and Medical Leave Act

  32. Socioeconomic Trends • Inequalities • Increasing rate of poverty • Wage gap

  33. Communications and the Digital Divide • Access to the Internet and information • Limited or no access to the Internet • Poor • Elderly

  34. Vulnerable Populations • Homeless • Undocumented immigrants and refugees • People who live in rural areas • Abused/neglected children • Victims of sexual violence • Victims of intimate partner violence

  35. Vulnerable Populations (cont’d) • Gay/lesbian/transgendered individuals • Incarcerated women • Substance abusers

  36. Personal and Cultural Trends • Technology • Language barriers • Cultural differences • Self-care/patient involvement • Autonomy • Social participation

  37. Complementary and Alternative Therapies • Integrative health care • Integrating CAM with conventional health care • NANDA-I diagnoses for holistic nursing • www.ahna.org

  38. Health Care for the Nation • Growth of information and knowledge • Access to current and accurate knowledge critical • Community-based programs • High-tech medical care • Telemedicine

  39. Challenges for Nurses • An ethical framework for • professional practice

  40. Four Basic Ethical Principles • Beneficence • Nonmaleficence • Respect for autonomy • Justice or fairness

  41. HIPAA Implications • Procedural mandates for privacy • Portability • Precautions against health care fraud

  42. Current Trends in Clinical Practice • Electronic pumps • Paperless records • Unit dosing • Aging population • Evidence-based practice

  43. NANDA-I Nursing Diagnoses • NANDA-I • Nursing Interventions Classification • Nursing Outcomes Classification

  44. Chapter 3 The Evolving Family

  45. The Evolving Family • Viewing the family in a nursing context • Family is contextual background for patient • Healthy People 2010 National Initiative • Social policies • Access to health care

  46. Families Today • Definition of family • Family of origin/family of choice • Family changes as reflected in media • Family as a basic social unit

  47. Family Structure—Changes • Traditional nuclear families • Single head of household • The “skip” generation

  48. Stressors on Families • Health care • Financial stressors—uninsured • Homelessness • Mental illness • Societal pressures

  49. Family Theories and Models • Family Systems Theory • Boundaries • Subsystems • Balance and homeostasis

  50. Duvall’s Family Developmental Theory • The Beginning Stage • Childbearing Stage • Preschool Stage • School Age and Adolescent/Teenage Stages • Launching, Middle-Age, and Retirement Stages

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